Stigma of mental illness and help-seeking intention in university students

Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study

BACKGROUND

The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals.

AIMS

This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia.

METHODS

This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis.

RESULTS

Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns.

CONCLUSIONS

The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.

Effects of game-based digital interventions for mental disorders: A meta-analysis

With increasing research attention on game-based digital interventions for mental disorders, a number of studies have been conducted to explore the effectiveness of digital game-based interventions on mental disorders. However, findings from previous research were inconsistent. Thus, we conducted a comprehensive meta-analytic review of the effectiveness of game-based digital interventions for mental disorders. By searching the articles in databases, we identified 53 studies in which 2433 participants were involved, and 282 effect sizes were extracted. Among the 53 studies, 14 employed within-group (pre/post) designs, and the remaining 39 utilized controlled trial designs. Using a three-level random-effects meta-analytic model, a medium effect size of game-based digital interventions (g = 0.47, 95 % CI: 0.33, 0.61) was revealed in the controlled trial designs and a close-to-medium effect size (g = 0.45, 95 % CI: 0.32, 0.58) was found in the within-group (pre/post) designs, indicating close-to-medium-sized efficacy of game-based digital interventions for mental disorders. Moderator analyses showed that age in the controlled trial designs had contributed to the heterogeneity in previous studies, suggesting that interventions might be more effective for the elderly. However, given that only a limited number of studies were focused on the elderly, more studies with older participants should be conducted in the future to provide more robust evidence and explore the mechanisms of how digital gaming interventions can be more effective in improving mental disorders symptoms.

The impact of family history of mental illness on mental health help seeking in university students

BACKGROUND

University students with a family history of mental illness may have an increased risk of developing mental health problems.

AIMS

The aim of the study was to assess differences in mental health help seeking among students with a family history of mental illness compared to those without a family history.

METHODS

A total of 1127 university students, aged 18 to 30 years, completed an online survey with questions about mental illness, family history of mental illness, help seeking, and psychological symptoms.

RESULTS

Students with a family history of mental illness were more likely to report clinically significant symptoms and more likely to use social media and online support programs. They reported similar rates of in-person help seeking. Those with more than one family member with a mental illness reported greater symptom severity, more use of online programs, and increased likelihood of prescription drug use than those with only one family member.

CONCLUSIONS

More research is needed to understand how to increase access to mental health care and to address barriers to help-seeking considering family history of mental illness. University students may not be accessing appropriate treatment and care as required, with the rates of in-person help-seeking being low overall.

Stigma towards mental illness, resilience, and help-seeking behaviours in undergraduate students in Hong Kong

AIM

Early interventions have great impact on reducing burden of mental illness. Young people are however the least likely to seek help for psychological issues. Resilience and stigma towards mental illness have been identified as contributing factors, although previous findings were mixed with potentially complex interaction with symptom severity. We investigated the relationship between stigma, resilience, depressive symptom severity, and help-seeking behaviours in undergraduate students in Hong Kong.

METHODS

A cross-sectional online survey was conducted among undergraduates from a university in Hong Kong (n = 945). The 21-item Stigma and Acceptance Scale, Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-9 were used. History of help-seeking for psychological issues was self-reported. Path analysis was conducted to test a conceptual model of their relationships.

RESULTS

Among those with moderate-to-severe depressive symptoms (39.5%), only one-fourth had sought professional help. The path model showed that depressive symptom severity and stigma were positively associated with help-seeking behaviours, while resilience was negatively associated with help-seeking behaviours independently (all p < .001). Subgroup analyses showed differential contribution of stigma and resilience to a history of help-seeking in those with minimal-to-mild symptoms compared with moderate-to-severe symptoms.

CONCLUSIONS

Stigma may be a barrier for help-seeking particularly in students with moderate-to-severe depression. Higher levels of resilience in young people may be protective and reduce the unnecessary seeking of professional help. Therefore, enhancing resilience among students in general, and reducing stigma and promoting help-seeking behaviours for those who have moderate-to-severe symptoms should be consider in parallel as strategies to enhance mental wellbeing of students.

Stigma as a barrier to suicide prevention efforts in Iran

Suicide and suicide attempt affect a considerable part of the general population, and in spite of their prevalence, the stigma associated with suicide remains an unsolved problem surrounding this important public health problem, especially in lower-income countries such as Iran. Evidence shows that help-seeking from formal mental health services for suicidal people is low in countries like Iran. Previous studies on Iranian survivors of suicide attempts have shown that these people experience fear of stigma due to labels such as loss of faith in God, having forms of severe mental illnesses ("madness"), and being involved in unaccepted sexual relationships. The associated stigma prevents them from seeking appropriate health and social services. Although both self-stigma and public stigma contribute to an unwillingness to seek mental health care and suicide prevention efforts in Iran, public stigma may be of greater consequence, significantly impeding an individual's likelihood of accessing care for their suicidal thoughts or attempts. In such circumstances, many people with suicidal thoughts miss out on social and formal support programs offered by social and healthcare providers. In this perspective article, focusing on the public stigma regarding suicide in Iranian society, we address the challenges and barriers to seeking suicide prevention efforts in Iran and discuss culturally appropriate strategies to improve the current situation.

Factors Associated with Engagement in University Life, and Help Seeking Attitudes and Behaviour in First Year Undergraduate Students

Students transitioning from secondary school to university may experience unique issues that impact their mental health. There is limited research, however, on what drives first year students to seek professional help for mental health problems. There is also a current lack of knowledge about the factors that may be associated with engagement with university life in students transitioning to university, and how engagement may be related to help seeking attitudes and behaviours in a first year university population. Data (N = 165) were drawn from two waves (Wave 1, February 2021, and Wave 4, June 2021) of a longitudinal study of Australian university students commencing study for the first time, which included measures of engagement, belonging, stigma and help seeking intentions and behaviours. The results showed that students with higher levels of depression stigma prior to commencing university at Wave 1 had less positive attitudes towards help seeking at Wave 4. Students had increased odds of seeking help for a mental health problem in Wave 4 if they had moved away for university, reported higher levels of mental health literacy or willingness to disclose, had lower levels of engagement with university life and were experiencing higher levels of general psychological distress. Students experiencing higher thwarted belongingness were also found to have lower levels of engagement with university at Wave 4. Both thwarted belongingness and stigma were found to be associated with engagement with university and help seeking behaviours and should be examined further.

Effects of Shinrin-Yoku Retreat on Mental Health: a Pilot Study in Fukushima, Japan

Shinrin-yoku (forest bathing) is a cost-effective healing practice that has recently attracted the interest of social scientists who have attributed it, in part, to mental health benefits. Japanese university students suffer from high rates of mental health problems, and the number of suicides remains high despite the total number of suicides in Japan decreasing. Effective mental health approaches which increase mental wellbeing and self-compassion, and reduce associated deficits, such as loneliness, are sought after for Japanese students; however, healthful treatment has not been identified to date. Accordingly, this pre-post-pilot study evaluated the levels of mental wellbeing, self-compassion, and loneliness among 25 Japanese undergraduate students who participated in a three-day shinrin-yoku retreat in Fukushima. Measurements were taken prior, straight after, and two weeks post-intervention. One-way ANOVA with Tukey post hoc analysis revealed that the mean scores of self-compassion, common humanity, and mindfulness increased statistically significantly from pre-retreat to follow-up. The mean scores of mental wellbeing and loneliness did not statistically significantly change. The positive effects on self-compassion indicate that shinrin-yoku retreat should be evaluated within a larger sample and in a shorter time frame to establish optimal shinrin-yoku parameters in this arena.

Barriers and facilitators to help-seeking for common mental disorders among university students: a systematic review

Objectives: Common mental disorders affect high proportions of university students. This systematic review aims to summarize the barriers and facilitators to help-seeking for depression and anxiety among university students and provide evidence to improve mental health services. Methods: EMBASE, MEDLINE, and PsycINFO were searched for eligible papers. Inclusion criteria: (1) published between 1990 and 2021, (2) written in English, (3) had qualitative or quantitative methodology, (4) involved university students, (5) students had depression or anxiety, (6) students were explicitly asked about barriers and facilitators, (7) >60% of study population had mental illness. Results: Ten studies were included into this review. The most common barriers were self-reliance, stigma, and poor mental health literacy. Good mental health literacy and social encouragement were significant facilitators. Conclusions: Universities could encourage help-seeking by targeting stigma and increasing mental health literacy. Future research could explore the role of self-reliance in help-seeking and identify more facilitators.

Technology-Based Interventions to Improve Help-Seeking for Mental Health Concerns: A Systematic Review

BACKGROUND

Despite the high prevalence of mental health disorders worldwide, a significant proportion of distressed individuals do not seek professional help. Digital technology can be a potential bridge to reduce the treatment gap for mental disorders. A systematic review was undertaken to examine the technology-based interventions aimed at improving help-seeking attitude, intention, or behavior for mental health concerns.

METHODS

The literature search was conducted in January-February 2020 through various e-databases using relevant keywords that targeted help-seeking interventions for mental health disorders via different technology modes.

RESULTS

21 studies (15 randomized controlled trials and six non-randomized studies) were reviewed. The included studies were published between April 2006 to February 2020. Majority of the interventions led to an increase in the help-seeking variables. The crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking is highlighted. The review emphasizes the need for understanding utility of multicomponent interventions with personalized elements targeting help-seeking behavior, particularly in low-middle-income countries, and studies involving longer duration follow-ups.

CONCLUSION

This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health and suggests that such interventions play a crucial role in positively impacting help-seeking. The complex interplay between the relevant variables such as mental health literacy, stigma, help-seeking attitude, intention and behavior, and the intervention components that may have a differential bearing on these variables are issues that merit urgent attention in further research.

Seeking support for an eating disorder: a qualitative analysis of the university student experience-accessibility of support for students

BACKGROUND

While there is increased concern around mental health problems in universities, the experience of students with eating disorders (EDs) has received less attention. This is problematic as the detrimental consequences of a lack of adequate support are profound.

METHODS

A qualitative study was adopted to investigate students' perspectives of the availability, accessibility and suitability of support services. One hundred university students with experience of EDs completed an online survey. A further 18 students completed semi-structured interviews. Descriptive data are reported alongside analysis of qualitative data.

RESULTS

Three overarching themes were identified; awareness of support, confidence in asking for help and early experiences with services. Most students were aware of support through their GP and university counselling services. Few identified ED-specific sources of support. Barriers to help-seeking included self-stigma and gaps in service availability. Early experiences with services were often negative, problems included; difficulty accessing services, a lack of ED specific support and continuity of care between home and university.

CONCLUSIONS

There is substantive progress to be made in ensuring that students with EDs receive the support they need to thrive at university. While it is important that good treatments exist, the pathway to accessing these treatments equally important. As universities increasingly recognise the need for action around student mental health attention must also be directed towards EDs and the provision of specific services.

A Structural Equation Modeling of Mental Health Literacy in Healthcare Students

Background: There is a high prevalence of mental illness among healthcare students, and most students with mental health problems are reluctant to seek help from mental health professionals. Help-seeking is a component of mental health literacy (MHL). Although MHL is conceptualized as multi-dimensional, a theory-based multi-construct of MHL is still lacking. We aimed to build a theory-based multi-construct of MHL to explore the pathways of help-seeking. Methods: The data were obtained from a survey on MHL among healthcare students in 2018 (n = 1294). The Mental Health Literacy Scale for Healthcare Students was used to measure the maintenance of positive mental health, recognition of mental illness, mental illness stigma attitudes, help-seeking efficacy, and help-seeking attitudes. Descriptive analysis and structural equation modeling (SEM) were conducted. Results: The findings of the SEM model indicated recognition of mental illness had a positive direct effect on both help-seeking efficacy and maintenance of positive mental health. Additionally, help-seeking efficacy fully mediated the relationship between recognition of mental illness and help-seeking attitudes. Conclusions: Help-seeking efficacy plays a significant role in healthcare students' willingness to seek professional help when mental health care is needed. Accordingly, improving help-seeking efficacy strategies would increase the use of mental health services and contribute to the prevention of mental health problems.

Investigating Machine Learning & Natural Language Processing Techniques Applied for Predicting Depression Disorder from Online Support Forums: A Systematic Literature Review

Depression is a common mental health disorder that affects an individual’s moods, thought processes and behaviours negatively, and disrupts one’s ability to function optimally. In most cases, people with depression try to hide their symptoms and refrain from obtaining professional help due to the stigma related to mental health. The digital footprint we all leave behind, particularly in online support forums, provides a window for clinicians to observe and assess such behaviour in order to make potential mental health diagnoses. Natural language processing (NLP) and Machine learning (ML) techniques are able to bridge the existing gaps in converting language to a machine-understandable format in order to facilitate this. Our objective is to undertake a systematic review of the literature on NLP and ML approaches used for depression identification on Online Support Forums (OSF). A systematic search was performed to identify articles that examined ML and NLP techniques to identify depression disorder from OSF. Articles were selected according to the PRISMA workflow. For the purpose of the review, 29 articles were selected and analysed. From this systematic review, we further analyse which combination of features extracted from NLP and ML techniques are effective and scalable for state-of-the-art Depression Identification. We conclude by addressing some open issues that currently limit real-world implementation of such systems and point to future directions to this end.

Depression, stress and self-stigma towards seeking psychological help in veterinary students

Previous research indicates that the prevalence of depression among veterinarians and veterinary students is high. Although self-stigma in seeking psychological help is reportedly elevated in veterinary students, its impact on mental health has been largely unexplored. The aim of this study was to compare the levels of study-related stress, depression symptoms and self-stigma in veterinary students with those of non-veterinary students, and examine whether stress and self-stigma positively predicted depression symptoms in veterinary students. A total of 287 veterinary students and 317 non-veterinary students from Australian universities completed an online questionnaire measuring study-related stress, self-stigma and depression symptoms. Results showed that veterinary students reported significantly higher levels of stress and self-stigma than non-veterinary students, but there was no significant difference between veterinary and non-veterinary students in depression symptoms. Multiple regression analysis indicated that stress and self-stigma both predicted depression symptoms in veterinary students. These findings suggest that reducing stress and help-seeking self-stigma in veterinary students may be important in improving their wellbeing levels. These findings are important in developing a whole-of-career life course approach to understanding the professional and psychological experiences of veterinarians.

Advancing research to eliminate mental illness stigma: an interventional study to improve community attitudes towards depression among University students in Singapore

BACKGROUND

After decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students.

METHODS

390 university students from a local university in Singapore were voluntarily recruited for the study. The ARTEMIS intervention comprises an educational and social contact component, as well as a question and answer (Q&A) session with experts in the area of mental health. The Community Attitudes towards Mental Illness (CAMI) scale was administered at baseline, post-intervention and at 3-months follow-up. A confirmatory factor analysis (CFA) was conducted.

RESULTS

The CFA identified a 3-factor model for the CAMI with a decent fit (RMSEA = 0.06, CFI = 0.93, TLI = 0.93, SRMR = 0.06). Favourable shifts in attitudes across the factors were observed immediately after the intervention (p <  0.001). Gender (β = - 1.19, 95% CI: - 2.10, - 0.27, p = 0.01) and nationality (β = - 1.23, 95% CI: - 2.35, - 0.11, p = 0.03) were identified as significant correlates for the community mental health ideology (CMHI) factor. Linear effects indicated that having a close social contact with mental illness observed a smaller decrease in authoritarianism scores from pre- to post-intervention (β = 0.85, 95% CI: 0.18, 1.53, p = 0.01); whereas quadratic effects found a greater decrease in scores from post-intervention to after 3-months for benevolence (β = - 0.34, 95% CI: - 0.52, - 0.16, p <  0.001) and CMHI (β = - 0.22, 95% CI: - 0.45, - 0.002, p = 0.048).

CONCLUSION

The anti-stigma intervention shows promising short-term results across the CAMI dimensions even after adjusting for sociodemographic correlates. However, the intervention did not observe the sustained attitude shifts after 3-months. Recommendations for future anti-stigma interventions were also considered.

Attitudinal and demographic factors associated with seeking help and receiving antidepressant medication for symptoms of common mental disorder

BACKGROUND

Despite the increased attention given to improvement of mental health-related knowledge and attitudes, rates of help-seeking for mental illness remain low even in countries with well-developed mental health services. This study examines the relationships between attitudes to mental illness, symptoms of common mental disorder and seeking-help and receiving medication for a mental health problem.

METHODS

We used data from the nationally representative Health Survey for England 2014 to design three logistic regression models to test for the effects of attitudes to mental illness (measured by a shortened version of the Community Attitudes toward the Mentally Ill, CAMI scale) on: recent contact with a doctor for a mental health problem; use of any type of mental health service in the last 12 months; and having antidepressants currently prescribed, while controlling for symptoms of common mental disorder (measured by the General Health Questionnaire, GHQ). We also tested for an interaction between attitudes to mental illness and symptoms of common mental disorder on the outcomes.

RESULTS

A significant but very small effect of CAMI score was found on 'antidepressants currently prescribed' model (OR = 1.01(1.00, 1.02) but not on the two indicators of help-seeking. We also found a significant but very small interaction between CAMI and GHQ scores on recent contact with a doctor (OR = 0.99, 95% CI (0.990, 0.998); adjusted Wald test P = 0.01)). Knowing someone with a mental illness had a significant positive effect on help-seeking indicated by: (a) recent contact with a doctor (2.65 (1.01, 6.98)) and (b) currently prescribed antidepressant (2.67 (1.9, 3.75)) after controlling for attitudes to mental illness.

CONCLUSIONS

Our results suggest that knowing someone with a mental health problem seems to have a further positive effect on help-seeking, beyond improving attitudes to mental illness. Furthermore, multiple different types and aspects of stigma may contribute to help-seeking behaviours, consequently multi-faceted approaches are likely to be most efficient.

Depression Severity and Depression Stigma Among Students: A Survey of Universities in Five Countries

In the university setting, mental disorders have come under greater scrutiny and more attention has been given toward addressing the social stigmas associated with mental illness in an effort to promote mental well-being and improve mental health care delivery on-campus. Depression has been previously linked to a reduction in quality of life, suicidal ideation, and poor academic performance. However, few studies have directly compared the burden of depression or stigmatized views between multiple universities. As a result, this cross-sectional study of university students from five countries was performed to determine the burden of depressive disorders, the stigmatizations of beliefs related to depression, and international variation. A questionnaire consisting of a sociodemographic survey, Patient Health Questionnaire-9 (PHQ-9), and Depression Stigma Scale (DSS) was distributed via multiple routes to undergraduate and graduate students at institutions in the United States, Taiwan, United Arab Emirates, Egypt, and Czech Republic. The point prevalence of depression was determined by using the algorithm scoring method of the PHQ-9. Depression severity was determined according to the summed-item scoring method of the PHQ-9. The degree of stigmatization of beliefs was determined by continuous scores on the DSS subscales for personal and perceived stigma. Differences in depression severity, personal stigma, and perceived stigma were determined according to analysis of variance and further studied using post hoc Tukey's tests. Responses were collected from students in the United States (n = 593), United Arab Emirates (n = 134), Taiwan (n = 217), Egypt (n = 105), and Czech Republic (n = 238). Of 1287 responses, 30.7% (n = 396) screened positive for a depressive disorder: 18.0% (n = 232) for major depressive disorder and 12.7% (n = 164) for another depressive disorder. Depression severity differed internationally (p < 0.001). Emirati students significantly exhibited most depression followed by Czech, American, and Taiwanese students (all ps < 0.001). There was also a difference between students of different countries in terms of personal stigma (p < 0.001), with Emirati students holding more stigmatized personal views than Czech, American, Egyptian, and Taiwanese students (all ps < 0.001). Students similarly demonstrated differences in terms of personal stigma (p < 0.001). Egyptian students exhibited the most perceived stigma followed by Emirati, Taiwanese, American, and Czech students (all ps < 0.001). These findings suggest a high point prevalence of depression among university students and differences in the severity of depression, which has implications for the delivery of mental health care in this population. There were significant differences in terms of personal and perceived stigma between university students, indicating resource allocation for university-based campaigns to reduce depression stigma may need to be tailored to the population. After implementation of stigma reduction programs, future follow-up surveys can be done to compare degrees of stigma before and after the intervention.

Mental distress, perceived need, and barriers to receive professional mental health care among university students in Ethiopia

BACKGROUND

There is limited evidence on the extent of the perceived need and barriers to professional mental health service delivery to university students with mental distress in low- and middle-income countries (LMICs). This study was designed to assess the prevalence of mental distress, perceived need for professional mental health care and barriers to the delivery of services to affected undergraduate university students in Ethiopia.

METHODS

A multi-stage sampling technique was used to recruit 1135 undergraduate university students. Symptoms of mental distress were evaluated using the Self-Reported Questionnaire (SRQ-20) and a score of above seven was used to identify positive cases. The perceived need for professional mental health care was assessed using a single 'yes or no' response item and barriers to mental health care were assessed using Barriers to Access to Care Evaluation (BACE-30) tool. Percentage, frequency, mean, and standard deviation were employed to summarize demographic characteristics of the participants and to identify common barriers to mental health care service. Moreover, the association of demographic variables with total mean scores of BACE-III sub-scales was modeled using multiple linear regression.

RESULTS

The prevalence of mental distress symptoms was 34.6% and the perceived need for professional mental health care was 70.5% of those with mental distress. The top five barriers to receiving professional mental health service were (a) thinking the problem would get better with no intervention, (b) being unsure where to go to get professional help, (c) wanting to solve the problem without intervention, (d) denying a mental health problem existed, and (e) preferring to get alternative forms of mental care. Coming from a rural background, being a second and fourth-year student, and a family history of mental illness were significantly associated with barriers to receive professional mental health service.

CONCLUSION

The high prevalence of mental distress, the paucity of mental health care, and the report of barriers to access what professional mental health care there is among Ethiopian undergraduate students is a call to address the disparity.

Pharmacy and Medical Students' Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors

Objective. To examine and compare the prevalence of mental health problems, help-seeking attitudes, and perceptions about mental health problems among US pharmacy and medical students. Methods. A cross-sectional analysis was conducted using existing, anonymous survey data collected in the Healthy Minds Study during the 2015-2016 academic year. The analysis included 482 students (159 pharmacy students and 323 medical students) from 23 institutions in the United States. Analyzed topics included demographic characteristics, mental health status and symptoms, substance abuse, stigma related to mental health, help-seeking behaviors and attitudes, and mental health treatment perceptions. Results. Pharmacy and medical students experienced similar rates of depression (18% met clinical cut-offs), but pharmacy students were more likely to meet clinical cutoffs for anxiety (21% vs 11%). Pharmacy students were less likely to seek help from student counseling services (only 11% vs 49%) and also less likely to know where to seek help on campus if needed. Pharmacy students also reported having higher levels of stigma regarding mental health treatment. Conclusion. There are differences between pharmacy and medical students with regards to their experience of mental health symptoms, willingness to seek help, and perception of stigma. Despite the small sample, this analysis of national data indicates that opportunities exist to improve campus-based mental health education and offerings for pharmacy and medical students.

Mental health services in the Philippines

National information on mental health services in the Philippines indicates that there are substantial gaps and inconsistencies in the delivery of mental healthcare. The recently enacted Mental Health Act legislation provides a platform for the delivery of comprehensive and integrated mental health services. However, there remain many challenges in the provision of accessible and affordable mental healthcare.

Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia

BACKGROUND

Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated.

METHODS

University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI).

RESULTS

Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p < .001), general help-seeking attitude (r = .156, p = .027), and age (r = .187, p < .001). However, the strongest predictor for mental help-seeking attitude was self-stigma on seeking help (F (2,199) = 8.207, p < .001 with R² of .076). University students had better depression literacy and lower levels of self-stigma and negative beliefs toward mental illness compared to secondary school students.

CONCLUSION

Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.

Stigma and Attitude of Mental Health Help-Seeking Among a Sample of Working Versus Non-working Egyptian Women

This study was conducted to assess the level of mental health difference between working and non-working women, to explore their stigma and attitude toward seeking psychological help for mental-health problems. World Health Organization's Self-reporting questionnaire (SRQ-20), adoption of Discrimination-Devaluation scale (D-D) scale for measuring self-stigma and attitude toward Seeking Mental Health Services (IASMHS) Inventory were used. The sampled teachers reported a higher attitude towards seeking mental health services when compared to housewives. Social support and personal stigma were the main factors that significantly predict total IASMHS. Although working females are more susceptible to mental health disorders, yet less stigmatized towards mental health problems and a better attitude for seeking mental health services than housewives.

Mental Health Stigma and Veterinary Medical Students' Attitudes Toward Seeking Professional Psychological Help

Veterinary medical students may be at increased risk for a variety of mental health problems. However, research with student samples suggests that students in distress may not seek professional help, even when mental health services are available. The purpose of this study was to explore veterinary students' willingness to seek mental health services for several common presenting concerns, as well as their perceptions of their peers' willingness to seek help for the same concerns. We also sought to explore the roles of public stigma, self-stigma, and attitudes toward seeking professional psychological help in explaining students' willingness to seek services using a serial mediation analysis. Study participants were 573 veterinary medical students currently enrolled in accredited programs in the United States. Participants reported being most willing to seek mental health services for issues regarding substance abuse, traumatic experiences, and anxiety. They also tended to perceive other students were less willing to seek mental health services for most presenting issues than they actually were. As expected, self-stigma and attitudes toward seeking professional psychological help serially mediated the relationship between public stigma and willingness to seek mental health services. Public stigma was positively related to self-stigma, self-stigma was negatively related to attitudes toward seeking professional psychological help, and attitudes toward seeking help were positively related to willingness to seek mental health services. Implications for outreach, research, and education are discussed.

Predicting intentions to seek help for depression among undergraduates in Sri Lanka

BACKGROUND

Studies have found that although there are high rates of depression among university students, their help-seeking practices are poor. It is important to identify students who are less likely to seek the necessary help, to encourage better help-seeking among them. This study, which was conducted among undergraduates in Sri Lanka, examined the associations between personal characteristics of the undergraduates and their intentions to seek help for depression.

METHODS

This was a cross-sectional study in which 4461 undergraduates (Male: n = 1358, 30.4%, Female: n = 3099, 69.5%; Mean age = 22.18; SD = 1.47) indicated their intentions to seek help if personally affected by depression, which was described in a hypothetical vignette about a peer experiencing depression symptomatology. The predictors of the undergraduates' help-seeking intentions, including their sociodemographic characteristics, prior exposure to and recognition of the problem, and their stigma towards those with depression were examined using binary logistic regression analyses models.

RESULTS

The undergraduates' ability to recognise the problem was one of the strongest predictors of their intentions to seek professional help. Those with higher levels of stigma were less likely to seek both professional and informal help. While females were less likely to consider professional help, they were more likely to consider the help of informal help-providers and to consider religious strategies. Medical undergraduates and those who had sought help for personal experiences of the problem were also more likely to consider informal help. However, all these associations resulted in small effect sizes, except for those between recognition of the problem and the undergraduates' intentions to seek professional help, where medium to very large effect sizes were observed in the case of some the associations examined.

CONCLUSIONS

Improvement of problem-recognition may be a key strategy for improving help-seeking among these undergraduates. Reduction of stigma may also be associated with better depression-related help-seeking of undergraduates. Females and medical undergraduates need to be educated about the importance of seeking appropriate types of help, and their informal social networks must be educated about how best to help them.

Undergraduate Students' Exposure, Knowledge, Utilization, and Intended Use of the National Suicide Prevention Lifeline

Abstract. Background: Suicide is a leading cause of death among college students. Crisis hotlines play a role in linking suicidal individuals to help. Despite leading to favorable outcomes, low utilization of crisis outlines has been reported. Aims: To explore exposure, knowledge, and utilization of the National Suicide Prevention Lifeline (NSPL) among a sample of university students; to determine if knowledge and perceived helpfulness of NSPL predict intent to use NSPL. Method: The researcher surveyed 560 students attending a Midwestern university to assess knowledge of, and attitudes toward, the NSPL. Results: Those who reported seeing the NSPL advert (50%) perceived the NSPL to be more helpful than those who had not seen the advert. Only 29% (n = 160) were able to identify who would answer the NSPL (a trained, skilled counselor). Only 1% (n = 4) reported utilization. Participants who reported past exposure to the NSPL advert reported higher levels of perceived helpfulness of the NSPL. Perceived helpfulness of the NSPL was a weak predictor of likelihood to use the NSPL. Limitations: The study limitations include its small sample size; participants' likelihood to use the NSPL was assessed using independent symptoms. Conclusion: Further research is needed to identify college students' underlying attitudes toward the NSPL.

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: "acceptance from peers," "personal challenges," "cultural and environmental influences," "self-medicating with alcohol," "perspectives around seeking professional help," "fear of homophobic responses," and "traditional masculine ideals." Five key themes of solutions to these barriers included "tailored mental health advertising," "integrating mental health into formal education," "education through semiformal support services," "accessible mental health care," and "making new meaning." Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems.

Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis

BackgroundMental disorders create high individual and societal costs and burden, partly because help-seeking is often delayed or completely avoided. Stigma related to mental disorders or mental health services is regarded as a main reason for insufficient help-seeking.AimsTo estimate the impact of four stigma types (help-seeking attitudes and personal, self and perceived public stigma) on active help-seeking in the general population.MethodA systematic review of three electronic databases was followed by random effect meta-analyses according to the stigma types.ResultsTwenty-seven studies fulfilled eligibility criteria. Participants' own negative attitudes towards mental health help-seeking (OR = 0.80, 95% CI 0.73-0.88) and their stigmatising attitudes towards people with a mental illness (OR = 0.82, 95% CI 0.69-0.98) were associated with less active help-seeking. Self-stigma showed insignificant association (OR = 0.88, 95% CI 0.76-1.03), whereas perceived public stigma was not associated.ConclusionsPersonal attitudes towards mental illness or help-seeking are associated with active help-seeking for mental problems. Campaigns promoting help-seeking by means of fighting mental illness-related stigma should target these personal attitudes rather than broad public opinions.

Help-seeking behaviors and mental well-being of first year undergraduate university students

University students demonstrate poor help-seeking behatabviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-betabing, and to extaplore these students' views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a universitytab in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students' knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.

Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample

Perceived public stigma regarding seeking mental health treatment can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma have received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample of 386 primarily White and Asian college students. Participants completed surveys of mental health symptoms, treatment experience and attitudes, perceived public, and personal stigma. Overall, participants generally reported greater perceived public stigma than personal stigma; an effect that was particularly evident for women and those with mental health symptoms. The majority of participants disagreed with items assessing personal stigma. Negative attitudes toward treatment and anxiety symptoms associated with perceived public stigma, while male gender, Asian ethnicity, and negative attitudes toward treatment associated with personal stigma. Findings have implications for interventions and marketing programs to help change perceptions about mental health stigma to encourage utilization of services for those young people who could benefit from care.